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MANAGEMENT MANAGEMENT OF SPORT OF SPORT
INJURY INJURY
UNIVERSITI UNIVERSITI TEKNOLOGI MARA TEKNOLOGI MARA (UiTM)(UiTM)
FAKULTI SAINS SUKAN & REKREASIFAKULTI SAINS SUKAN & REKREASIDR ANUAR B. SUUNDR ANUAR B. SUUN
E-mail: E-mail: [email protected]@salam.uitm.edu.myTelTel : 0192338646 : 0192338646
sportsINJURY/anuar2005sportsINJURY/anuar2005 33
TERMINOLOGYTERMINOLOGY
‘‘..SPORTS INJURY can ..SPORTS INJURY can be broadly defined be broadly defined as any injury occurs as any injury occurs due to sporting and due to sporting and vigorous physical vigorous physical activities’activities’
sportsINJURY/anuar2005sportsINJURY/anuar2005 44
SPORTS MEDICINE TEAMSPORTS MEDICINE TEAM
• THE NURSETHE NURSE• PHYSICIANSPHYSICIANS• ORTHOPEDISTORTHOPEDIST• NEUROLOGISTNEUROLOGIST• INTERNISTINTERNIST• OPTHALMOLOGISTOPTHALMOLOGIST• PEDIATRICIANPEDIATRICIAN• PSYCHIATRISTPSYCHIATRIST• DENTISTDENTIST• PODIATRISTPODIATRIST• PHYSICIAN’S PHYSICIAN’S
ASSISTANTASSISTANT• PHYSICAL PHYSICAL
THERAPISTTHERAPIST
• STRENGTH& STRENGTH& CONDITIONING CONDITIONING SPECIALISTSPECIALIST
• BIOMECHANISTBIOMECHANIST• EXERCISE EXERCISE
PHYSIOLOGISTPHYSIOLOGIST• NUTRITIONISTNUTRITIONIST• SPORT SPORT
PSYCHOLOGISTPSYCHOLOGIST• SOCIAL WORKERSOCIAL WORKER• EQUIPMENT EQUIPMENT
PERSONNELPERSONNEL
sportsINJURY/anuar2005sportsINJURY/anuar2005 55
ROLES OF SPORTS ROLES OF SPORTS MEDICINEMEDICINE
• Prevent injuryPrevent injury• Providing initial first aid & injury Providing initial first aid & injury
managementmanagement• Evaluate injuryEvaluate injury• Treatment, rehabilitation & Treatment, rehabilitation &
reconditioningreconditioning• MotivationMotivation• Ensuring a safe playing environmentEnsuring a safe playing environment• Explaining the important of nutritionExplaining the important of nutrition• Conducting physical examinationConducting physical examination• ORGANIZATION & ADMINISTRATION – ORGANIZATION & ADMINISTRATION –
record keeping, ordering equipment and record keeping, ordering equipment and supplies, supervising personnelsupplies, supervising personnel
• Referral to physician, health services & Referral to physician, health services & hospitalshospitals
sportsINJURY/anuar2005sportsINJURY/anuar2005 66
• AgeAge• SexSex• SizeSize• Body compositionBody composition• Muscle powerMuscle power• Muscle weaknessMuscle weakness• Muscle imbalanceMuscle imbalance• Muscle stiffnessMuscle stiffness• Lack of flexibilityLack of flexibility• Malalignment Malalignment
• SurfacesSurfaces• EquipmentEquipment• environmental environmental
conditioncondition• training errorstraining errors• psychological psychological
factorsfactors• inadequate inadequate
nutritionnutrition• training method & training method &
competition competition
sportsINJURY/anuar2005sportsINJURY/anuar2005 77
3 types of bleeding in blood vessels3 types of bleeding in blood vessels
Arteries
• carry OXYGENATED blood from the heart to the body
• loss of blood from artery is always serious & profuse
• bright red blood flows freely from the wound in spurts that occur each time the heart beat
Venous
• veins carry DEOXYGENATED blood back to the heart
•If large vein is injured, bleeding maybe profused; does not display the spurts seen in arterial bleeding
•The loss is as steady flow, with dark red/maroon in color
Capillaries
•Between vein & arteries-exchange between the blood & the tissues takes place
•Capillaries bleed is the least serious form of bleeding but should be controlled & the step should be taken to reduce contamination
sportsINJURY/anuar2005sportsINJURY/anuar2005 88
CONTROLLING EXTERNAL CONTROLLING EXTERNAL BLEEDINGBLEEDING
Apply pressure with dressing (sterile dressing)
Function if direct/indirect & elevation pressure have failed to control the bleeding adequately
11 arterial pressure-point sites on each side of the body
THIGH – femoral artery to the leg
UPPER ARM – Brachial artery pressure point is use to control profuse bleeding
When the limb is elevated, the effects of gravity will help lower the blood pressure in the injured part & reduce the flow
sportsINJURY/anuar2005sportsINJURY/anuar2005 99
CARES FOR BLEEDINGCARES FOR BLEEDINGHave someone alert the EMS system dispatcherHave someone alert the EMS system dispatcher
Provide an open airway & Provide an open airway &
monitor the PULSEmonitor the PULSE
Keep the athlete at rest & provideKeep the athlete at rest & provide
emotional supportemotional support
Treat for shockTreat for shock
Loosen restrictive clothingLoosen restrictive clothing
Refrain from giving the athlete anything by mouth & Refrain from giving the athlete anything by mouth & be prepared for vomitingbe prepared for vomiting
Splint fractures when appropriateSplint fractures when appropriate
Constantly monitor the athlete until the EMS system Constantly monitor the athlete until the EMS system can respondcan respond
sportsINJURY/anuar2005sportsINJURY/anuar2005 1010
PRINCIPLES OF WOUND PRINCIPLES OF WOUND CARECARE
CLINICAL FEATURES
OPEN WOUND
CLOSED WOUND•Happen outer layer of
the skin
•External body
E.g. Abrasions, punctures, cuts, avulsions, incised, burning, amputation
•Happen in our body OR under the skin
• Internal body
E.g. sprain, strain, contusion, fracture/dislocation, bruises, swelling
sportsINJURY/anuar2005sportsINJURY/anuar2005 1111
CARES FOR OPEN WOUNDCARES FOR OPEN WOUND
EXPOSE WOUND
Clean & clear the wound
surface
Control bleeding
Apply a dressing
Bandage a dressing
Reassure the athlete
sportsINJURY/anuar2005sportsINJURY/anuar2005 1212
COMPLICATIONCOMPLICATION
Shock e.g. hypovolemic shockShock e.g. hypovolemic shock
Chronic blood loss e.g. anemia, Chronic blood loss e.g. anemia, hemoglobin decreasehemoglobin decrease
Infection OR contamination : Infection OR contamination : Tetanus, blood-born pathogenTetanus, blood-born pathogen
DeformityDeformity
Renal failureRenal failure
sportsINJURY/anuar2005sportsINJURY/anuar2005 1313
ShockShock
• Shock develops because Shock develops because the cardiovascular the cardiovascular system fails to supply an system fails to supply an adequate supply of adequate supply of blood to all the body’s blood to all the body’s vital tissuesvital tissues
• This causes a greater This causes a greater loss of blood, then loss of blood, then forces the heart to beat forces the heart to beat even more rapidlyeven more rapidly
HYPOVOLEMIC TOXIC OR CHEMICAL
ANAPHYLACTIC
SEPTIC NEUROGENIC
sportsINJURY/anuar2005sportsINJURY/anuar2005 1414
CARE FOR SHOCKCARE FOR SHOCK
Have someone alert the EMS system Have someone alert the EMS system dispatcherdispatcher
Keep the athlete at rest, lying downKeep the athlete at rest, lying down Ensure open airway & breathingEnsure open airway & breathing Control all serious external bleedingControl all serious external bleeding Splint major fracturesSplint major fractures Elevate uninjured lower extremitiesElevate uninjured lower extremities Prevent loss of body heatPrevent loss of body heat Give nothing by mouthGive nothing by mouth Assess PULSE & respirations at least Assess PULSE & respirations at least
once every 5 minutesonce every 5 minutes
sportsINJURY/anuar2005sportsINJURY/anuar2005 1515
Nerve, Nerve, ligaments, ligaments, Tendons, Tendons, Muscles, Fascia, Muscles, Fascia, Cartilage Cartilage (Meniscus) being (Meniscus) being categorized as categorized as soft tissues soft tissues except for boneexcept for bone
Soft tissue or non-bony tissue is categorized Soft tissue or non-bony tissue is categorized as contractile and contractileas contractile and contractile
@NONCONTRACTILE TISSUE – @NONCONTRACTILE TISSUE – Skin, joint capsules, ligaments, Skin, joint capsules, ligaments,
fascia, fascia, cartilage, dura- meter, and cartilage, dura- meter, and nerve nerve roots roots
@CONTRACTILE TISSUES –@CONTRACTILE TISSUES – Muscles, tendons, or its bony Muscles, tendons, or its bony
insertioninsertion
• Many of these injuries create symptoms of Many of these injuries create symptoms of inflammation & degenerative tissue inflammation & degenerative tissue responsesresponses
• These all injuries may be result of a single These all injuries may be result of a single episode of injury OR as a result of episode of injury OR as a result of repeated overuse where can damage and repeated overuse where can damage and painpain
sportsINJURY/anuar2005sportsINJURY/anuar2005 1616
swelling
Bruises
Discoloration
Rupture
Contusion
Sprain
Strain
Hematoma
sportsINJURY/anuar2005sportsINJURY/anuar2005 1717
CRYOTHERAPY (Cold therapy)CRYOTHERAPY (Cold therapy)Any used of ice or cold applied Any used of ice or cold applied for therapeutic purposes. Result for therapeutic purposes. Result in the withdrawal of HEAT in the withdrawal of HEAT from the bodyfrom the body
• Use of COLD – in ACUTE and Use of COLD – in ACUTE and SUBACUTE injurySUBACUTE injury
• Multiple type of cold applied that Multiple type of cold applied that used the type of electromagnetic used the type of electromagnetic energyenergy
• Immediate skin coolingImmediate skin cooling• The depth can reach 5cmThe depth can reach 5cm• Classification as infrared radiationClassification as infrared radiation
– COLD is applied, HEAT is COLD is applied, HEAT is removedremoved
– 15mins cold application15mins cold application
TYPE OF CRYOTHERAPY
*Flaked ice in towel
*Flaked ice in plastic bag
*Ice massage
*Cold spray
*Ice bath
*Cold compression
*Ice immersion
sportsINJURY/anuar2005sportsINJURY/anuar2005 1818
USES OF USES OF CRYOTHERAPYCRYOTHERAPY
• Decrease Decrease metabolismmetabolism
• Decrease circulationDecrease circulation
• Decrease painDecrease pain
• Decrease muscle Decrease muscle spasmspasm
• Decrease Decrease inflammationinflammation
• StiffnessStiffness
EFFECTEFFECT
• IMMEDIATE – To IMMEDIATE – To limit the body limit the body response response (swelling, pain, (swelling, pain, muscle spasm)muscle spasm)
• REHABILITATION – REHABILITATION – To restore To restore functionfunction
sportsINJURY/anuar2005sportsINJURY/anuar2005 1919
CPR or Cardiopulmonary CPR or Cardiopulmonary Resuscitation is used to Resuscitation is used to prevent biological death prevent biological death when someone is when someone is experiencing cardiac experiencing cardiac arrestarrest
• The person will not be The person will not be RESPONSIVE, BREATH & RESPONSIVE, BREATH & CIRCULATING BLOODCIRCULATING BLOOD
• The techniques applied The techniques applied during CPR provide the during CPR provide the athlete with air & athlete with air & circulation circulation
COMPLICATIONSCOMPLICATIONS#Athlete injury#Athlete injury#Gastric distention#Gastric distention#REGURGITATION OR vomiting#REGURGITATION OR vomiting
sportsINJURY/anuar2005sportsINJURY/anuar2005 2020
Procedures of CPR for the adult victimsProcedures of CPR for the adult victims(one rescuer CPR)(one rescuer CPR)
Determine unresponsiveness, position athlete, open airway,Determine unresponsiveness, position athlete, open airway,
Look, listen & feel (3 to 5 seconds for breathing)Look, listen & feel (3 to 5 seconds for breathing)
Deliver 2 breaths at 1 to 1 ½ seconds per ventilationDeliver 2 breaths at 1 to 1 ½ seconds per ventilation
Check carotid pulse for 5 to 10 seconds if NO pulse, then Check carotid pulse for 5 to 10 seconds if NO pulse, then begin chest compressionsbegin chest compressions
COMPRESSIONCOMPRESSION
80 to 100/min (15/9 to 11 sec)80 to 100/min (15/9 to 11 sec)
VENTILATIONSVENTILATIONS
2 ventilations/15 compressions2 ventilations/15 compressions
Do 4 cycles, then check PULSEDo 4 cycles, then check PULSE
DO PERIODIC ASSESSMENT OF BREATHING & PULSEDO PERIODIC ASSESSMENT OF BREATHING & PULSE
sportsINJURY/anuar2005sportsINJURY/anuar2005 2121
• #A partial or complete interruption in a bone continuity
• #It can occur without external exposure or can extend through the skin, creating an external wound (open fracture)
• #A sudden, violent muscle contraction or repetitive abnormal stress to a bone also cause a fracture
• # A dislocation occurs # A dislocation occurs whenever one end of a whenever one end of a bone that makes up a joint bone that makes up a joint is pulled out of placeis pulled out of place
• # the mechanism of injury # the mechanism of injury is forceful, i.e. a blow OR a is forceful, i.e. a blow OR a twisting OR pulling actiontwisting OR pulling action
• # soft tissues are # soft tissues are damaged in all cases of damaged in all cases of dislocationdislocation
FRACTURE DISLOCATION
sportsINJURY/anuar2005sportsINJURY/anuar2005 2222
Type of fractureType of fracture
• SPIRALSPIRAL #Torsional force; common in football #Torsional force; common in football & skiing, sports in which the foot is firmly & skiing, sports in which the foot is firmly planted when the body is suddenly rotated in planted when the body is suddenly rotated in an opposing directionan opposing direction
• TRANSVERSETRANSVERSE #Direct blow; occurs in #Direct blow; occurs in straight line, more or less at right angles to straight line, more or less at right angles to the bone shaftthe bone shaft
• OBLIQUEOBLIQUE #Direct blow; occurs when one end #Direct blow; occurs when one end of the bone receives sudden torsion or of the bone receives sudden torsion or twisting while the other end is fixed or twisting while the other end is fixed or stabilizedstabilized
• AVULSIONAVULSION #is the separation of a bone #is the separation of a bone fragment from its cortex at an attachment of fragment from its cortex at an attachment of a ligament or tendon. This fracture usually a ligament or tendon. This fracture usually occurs as a result of a sudden, powerful twist occurs as a result of a sudden, powerful twist or stretch of a body partor stretch of a body part
• GREENSTICKGREENSTICK #Incomplete breaks in bones #Incomplete breaks in bones that have not completely ossified e.g. that have not completely ossified e.g. adolescents.adolescents.
• COMMINUTED #consist of three or more COMMINUTED #consist of three or more fragments at the fracture sitefragments at the fracture site
• ? due to bone ? due to bone pierce skinpierce skin
• ? External force ? External force pierce skin & pierce skin & fracture bonefracture bone
• ? Infection ? Infection
CLOSED OPEN
sportsINJURY/anuar2005sportsINJURY/anuar2005 2323
SOUND OF
BREAKING
EXPOSED BONE TENDERNESS
SWELLING
DISCOLORATION
DEFORMITY MUSCLE SPASM
LOSS OF USE
TINGLING
SENSATION
GRATING
SOUNDLOSS OF NERVE
FUNCTION
sportsINJURY/anuar2005sportsINJURY/anuar2005 2424
IMMEDIATE TREATMENT FOR #IMMEDIATE TREATMENT FOR #
TOTAP Keep the person warm with the blanket to decrease the possibility of shock
Cut away the clothing, if possible, but do not move the injured part to do so
Follow the instruction of RICE
Call for Call for ambulance/physiambulance/physi
cian/specialistcian/specialist
sportsINJURY/anuar2005sportsINJURY/anuar2005 2525
• Restoration to a Restoration to a former capacity or former capacity or standing or to standing or to rank (to return the rank (to return the athlete to the athlete to the previous function) previous function)
• A restoration of A restoration of function to the function to the greatest possible greatest possible time in order to time in order to reach this goal reach this goal and achieve safeand achieve safe
sportsINJURY/anuar2005sportsINJURY/anuar2005 2626
MUSCLE CONDITIONING
FLEXIBILITY
PSYCHOLOGY
CORRECTION OF ABNORMAL
BIOMECHANIC
SPORTS SKILL
PROPRIOCEPTION
FUNCTIONAL
EXERCISE
MAINTENANCE OF CARDIORESPIRAT
ORY FITNESS
sportsINJURY/anuar2005sportsINJURY/anuar2005 2727
Therapeutic ModalitiesTherapeutic Modalities
• Cold Modalities – Cryotherapy (ice bag, ice pack, Cold Modalities – Cryotherapy (ice bag, ice pack, ice massage)ice massage)
• High-voltage galvanic stimulationHigh-voltage galvanic stimulation
• Heat modalities – Heat modalities –
Superficial Heating modalitiesSuperficial Heating modalities
@ Hydrocollator packs (Hot packs)@ Hydrocollator packs (Hot packs)
@ Parrafin@ Parrafin
@ Hydrotherapy (warm OR hot whirlpool)@ Hydrotherapy (warm OR hot whirlpool)
Deep Heating ModalitiesDeep Heating Modalities
@ Ultrasound@ Ultrasound
• Transcutaneous Electrical Nerve Stimulation Transcutaneous Electrical Nerve Stimulation (TENS)(TENS)
• ElectroacupunctureElectroacupuncture
sportsINJURY/anuar2005sportsINJURY/anuar2005 2828
NO PERSISTENT SWELLING,
BIOMECHANIC ABNORMALITY
PAIN-FREE ROM
GOOD PROPRIOCEPTIO
N
PHYSIOLOGICAL HEALING PROCESS
SKILL REGAINED
GRADUAL & PROGRESSIVE
RETURN TO SPORT
FUNCTIONAL TESTING
PSYCHOLOGICAL READY
FUNCTIONAL TESTING
ADEQUATE CV FITNESS
GOOD FLEXIBILITY
ADEQUATE STRENGTH & ENDURANCE
PROPHYLACTIC BRACING,
STRAPPING
sportsINJURY/anuar2005sportsINJURY/anuar2005 2929
CAUSES CAUSES CLINICAL CLINICAL FEATURESFEATURES
& DIAGNOSIS & DIAGNOSIS
TREATMENTTREATMENT PREVENTIONPREVENTION
HEAT HEAT CRAMPCRAMP
Hard work in Hard work in heat; heat; sweating sweating heavily; heavily; imbalance imbalance between between water & water & electrolyteselectrolytes
Muscle twitching & Muscle twitching & cramps, usually after cramps, usually after midday; spasms in midday; spasms in arms, legs, abdomen arms, legs, abdomen
Ingesting large Ingesting large amount of water, amount of water, mild stretching, & mild stretching, & ice massage of ice massage of affected muscle affected muscle
Acclimatize Acclimatize athlete properly; athlete properly; provide large provide large quantities of quantities of water; increase water; increase intake of intake of calcium, sodium, calcium, sodium, & potassium & potassium slightly slightly
HEATHEAT
EXHAUSTIEXHAUSTIONON
Prolonged Prolonged sweating; sweating; inadequate inadequate replacement replacement of body fluid of body fluid losses; losses; diarrhea; diarrhea; intestinal intestinal infectioninfection
Excessive thirst, dry Excessive thirst, dry tongue & mouth; weight tongue & mouth; weight loss; fatigue; weakness; loss; fatigue; weakness; in-coordination; mental in-coordination; mental dullness; small urine dullness; small urine volume; slightly volume; slightly elevated body elevated body temperature; high temperature; high serum protein & serum protein & sodium; reduced sodium; reduced swelling swelling
Bed rest in cool Bed rest in cool room, increase fluid room, increase fluid intake to 6-8L/day; intake to 6-8L/day; sponge with cool sponge with cool water; keep record water; keep record of body weight; of body weight; keep fluid balance keep fluid balance record; provide record; provide semiliquid food semiliquid food until salination is until salination is normalnormal
Supply adequate Supply adequate water and other water and other liquids; provide liquids; provide adequate rest & adequate rest & opportunity for opportunity for coolingcooling
sportsINJURY/anuar2005sportsINJURY/anuar2005 3030
Con’t_________________________________Con’t_________________________________
CAUSES CAUSES CLINICAL FEATURESCLINICAL FEATURES
& DIAGNOSIS & DIAGNOSIS TREATMENTREATMEN
TTPREVENTIOPREVENTIO
NN
HEATHEAT
STROKSTROKEE
Thermo-Thermo-regulatory regulatory failure of failure of sudden onset sudden onset
Abrupt onset, preceded by Abrupt onset, preceded by headache, vertigo, & fatigue; headache, vertigo, & fatigue; flushed skin; relatively less flushed skin; relatively less sweating that seen with heat sweating that seen with heat exhaustion; pulse rate exhaustion; pulse rate increases rapidly & may reach increases rapidly & may reach 160-180; respiration increases; 160-180; respiration increases; BP seldom rises; temperature BP seldom rises; temperature rises rapidly to 105 or 106oF rises rapidly to 105 or 106oF (40-41oC); athlete feels as if (40-41oC); athlete feels as if he or she is burning up; he or she is burning up; diarrhea, vomiting; circulatory diarrhea, vomiting; circulatory collapse may produce death; collapse may produce death; could lead to permanent brain could lead to permanent brain damagedamage
Emergency Emergency measures to measures to reduce reduce temperature temperature must be taken must be taken immediately immediately (e.g. emersion (e.g. emersion in ice water in ice water bath or bath or sponge cool sponge cool water & air fan water & air fan over body, over body, massage massage limbs); limbs); remove to remove to hospital hospital
•Ensure proper Ensure proper acclimatization, acclimatization, proper proper hydrationhydration
•Educate those Educate those supervising supervising activities activities conducted in conducted in the heatthe heat
•Adapt Adapt activities to activities to environmentenvironment
sportsINJURY/anuar2005sportsINJURY/anuar2005 3131
Warming up & preparing Warming up & preparing specific muscles and the specific muscles and the body for the extra stress body for the extra stress of strenuous activitiesof strenuous activities
AIMS:AIMS:• To achieve better results To achieve better results
in training or in training or performance following itperformance following it
• To avoid damage to the To avoid damage to the muscles, tissues or body muscles, tissues or body due to long period of due to long period of physical activityphysical activity
ACTIVITIES:ACTIVITIES:
• Use all large muscles Use all large muscles groupgroup
• Be easy effort to BEGINBe easy effort to BEGIN
• Gradually build up to Gradually build up to moderate effortmoderate effort
• Continue (10 min) until Continue (10 min) until perspirationperspiration
• Be followed immediately Be followed immediately by muscle by muscle
• stretchingstretching
• Make it interesting!!Make it interesting!!
sportsINJURY/anuar2005sportsINJURY/anuar2005 3232
Gradually lower the Gradually lower the physiological function of physiological function of the body AFTER EXERCISE the body AFTER EXERCISE to avoid negative & to avoid negative & physiological effectsphysiological effects
• Slow down the Slow down the physiological functionphysiological function
• Breathing ExerciseBreathing Exercise• Light STRETCHINGLight STRETCHING
AIMSAIMS• Enhance RecoveryEnhance Recovery• Reduce the accumulation Reduce the accumulation
of LACTIC ACIDof LACTIC ACID
ACTIVITIESACTIVITIES
• Relaxing exerciseRelaxing exercise• 5 to 15 minutes duration5 to 15 minutes duration• Promote blood return to Promote blood return to
the heartthe heart• Decrease HEART RATEDecrease HEART RATE
sportsINJURY/anuar2005sportsINJURY/anuar2005 3333
Activities which lengthen the Activities which lengthen the muscle fibers muscle fibers (and mobilize) connective (and mobilize) connective tissuetissue
Increase range of movement Increase range of movement (ROM) at a joint(ROM) at a joint
WHY STRETCH?WHY STRETCH?• To decrease the risk of injuryTo decrease the risk of injury• To enable full development To enable full development
of opposing muscle groupof opposing muscle group• To increase mobilityTo increase mobility• To improve relaxationTo improve relaxation• Decrease STRESSDecrease STRESS• Improvement in postureImprovement in posture• Improve blood circulationImprove blood circulation
PRINCIPLES OF STRETCHINGPRINCIPLES OF STRETCHING
• Warm up prior to Warm up prior to stretchingstretching
• Stretch before and after Stretch before and after exerciseexercise
• Do not over stretch, Do not over stretch, particularly early stageparticularly early stage
• Gently & slowly stretchedGently & slowly stretched• Stretch to the point of Stretch to the point of
tension but never tension but never painpain
• Hold a stretched in a Hold a stretched in a comfortable positioncomfortable position
• A daily program produce A daily program produce better resultsbetter results
• Do Not BOUNCE!Do Not BOUNCE!
sportsINJURY/anuar2005sportsINJURY/anuar2005 3434
BENEFITS OF WARM-UP & BENEFITS OF WARM-UP & COOL-DOWNCOOL-DOWN
• INCREASE range of motion INCREASE range of motion (ROM)(ROM)
• Relaxed muscle attachmentRelaxed muscle attachment• Improved CoordinationImproved Coordination• More efficient movementMore efficient movement• DECREASE in common acute DECREASE in common acute
injuriesinjuries• REDUCE risk of overuse injuriesREDUCE risk of overuse injuries• Improved psychological Improved psychological
preparationpreparation• Improved performanceImproved performance
sportsINJURY/anuar2005sportsINJURY/anuar2005 3535
TECHNIQUESTECHNIQUES
• STATIC*STATIC* When a When a muscle or group of muscle or group of muscles are slowly muscles are slowly stretched and held for stretched and held for a short period (usually a short period (usually 8 to 12s)8 to 12s)
• PNF*(ProprioceptPNF*(Proprioceptive ive Neuromuscular Neuromuscular Facilitation)Facilitation) Based Based on reciprocal inhibition. on reciprocal inhibition. When a muscle is When a muscle is contracted, the contracted, the antagonist or opposing antagonist or opposing muscle is relaxedmuscle is relaxed
• PLYOMETRIC*PLYOMETRIC* Stretching-shortening cycle Stretching-shortening cycle ((myotatic stretch reflexmyotatic stretch reflex); ); Refers to exercise in which Refers to exercise in which the muscle is loaded in an the muscle is loaded in an eccentric (lengthening) eccentric (lengthening) contraction, followed contraction, followed immediately by a concentric immediately by a concentric (shortening) contraction(shortening) contraction
• ISOKINETIC*ISOKINETIC* means means ‘EQUAL MOTION’ or ‘EQUAL MOTION’ or maintaining the same speed maintaining the same speed of movement throughout the of movement throughout the ROMROMe.g. gym equipment e.g. gym equipment (specially design equipment (specially design equipment allows muscles to encounter allows muscles to encounter the same resistance for the same resistance for concentric & eccentric concentric & eccentric contractioncontraction
Con’t___________________________Con’t___________________________
sportsINJURY/anuar2005sportsINJURY/anuar2005 3636
Control any danger to self, athlete & othersControl any danger to self, athlete & others
Shake & ShoutShake & Shout
RESPONSERESPONSE NO RESPONSENO RESPONSE Make comfortableMake comfortable Turn athlete on Turn athlete on
side side
Observe ABCObserve ABC
Check for & manage BleedingCheck for & manage Bleeding
Check for & manage other injuries (STOP) Check for & manage other injuries (STOP) Open & clear airway Open & clear airway
DANGER
RESPONSE
AIRWAY
sportsINJURY/anuar2005sportsINJURY/anuar2005 3737
Con’t___________________________Con’t___________________________
Look, listen & feelLook, listen & feel
BREATHINGBREATHING NO NO BREATHINGBREATHING
Keep in side positionKeep in side position Turn athlete on Turn athlete on backbackObserve ABCObserve ABCCheck for & manageCheck for & manageBleedingBleeding
Check for & manageCheck for & manage Commence EAR Commence EAR other injuries (STOP) other injuries (STOP)
Pulse presentPulse present Not breathing, pulse Not breathing, pulse
absentabsentContinue EAR Continue EAR Commence CPR Commence CPR
Check pulse & breathing after 1 Mins Check pulse & breathing after 1 Mins Check pulse & breathing after 1 Check pulse & breathing after 1 Mins Mins & then every least 2 mins & then every least 2 mins & then every least 2 mins & then every least 2 mins
BREATHING
CIRCULATION
sportsINJURY/anuar2005sportsINJURY/anuar2005 3838
• Ask the player what happenAsk the player what happen• Where does it hurt?Where does it hurt?• What kind of pain is it?What kind of pain is it?
• Look at the affected area for REDNESS or Look at the affected area for REDNESS or SWELLINGSWELLING
• Is the injured side different from other side?Is the injured side different from other side?
• Touch will indicate warmth for inflammation – Touch will indicate warmth for inflammation – touch also assesses paintouch also assesses pain
• Ask the injured player to move the injured part Ask the injured player to move the injured part without any helpwithout any help
• If the player can move the injured part, carefully If the player can move the injured part, carefully try to move it yourself through its full range of try to move it yourself through its full range of motionmotion
• Did the active and passive movement produce Did the active and passive movement produce pain? If no, can the player stand & demonstrate pain? If no, can the player stand & demonstrate some of the skills from the game carefully?some of the skills from the game carefully?
• If an injury is identified, remove the player from If an injury is identified, remove the player from the activity immediatelythe activity immediately
TALK
OBSERVE
TOUCH
ACTIVE MOVT.
PASSIVE MOVT.
SKILLS
sportsINJURY/anuar2005sportsINJURY/anuar2005 3939
How?How? Why?Why?REST – Place the athlete in a comfortable REST – Place the athlete in a comfortable position, preferably lying down. The injured part position, preferably lying down. The injured part should be immobilized and supportedshould be immobilized and supported
Further activity will increase Further activity will increase bleeding & damagebleeding & damage
ICE – The conventional methods are:ICE – The conventional methods are:Crushed ice in a wet towel/plastic bagCrushed ice in a wet towel/plastic bagImmersion in icy waterImmersion in icy waterCommercial cold pack wrapped in wet towelCommercial cold pack wrapped in wet towelCold water from the tap is better than nothingCold water from the tap is better than nothing20mins application every 2hours for the first 20mins application every 2hours for the first 48hours48hours
Ice decreases:Ice decreases:SWELLINGSWELLINGPAINPAINMUSCLE SPASMMUSCLE SPASMSECONDARY DAMAGE SECONDARY DAMAGE TO THE INJURED AREATO THE INJURED AREA
COMPRESSION – Apply a wide compression COMPRESSION – Apply a wide compression bandage over a large area covering the injured bandage over a large area covering the injured part, as well as above & below the injurypart, as well as above & below the injury
Compression:Compression:Reduces bleeding & swellingReduces bleeding & swellingProvides support for the Provides support for the injured partinjured part
ELEVATION – Raised injured area above the level ELEVATION – Raised injured area above the level of the heart at all possible timesof the heart at all possible times
Elevation reduces:Elevation reduces:BLEEDINGBLEEDINGSWELLINGSWELLINGPAINPAIN
REFERRAL – Refer to a suitably qualified REFERRAL – Refer to a suitably qualified professional such a Doctor or Physiotherapist for professional such a Doctor or Physiotherapist for a definitive diagnosis & ongoing carea definitive diagnosis & ongoing care
Early referral for a definitive Early referral for a definitive diagnosis to as certain the exact diagnosis to as certain the exact nature of the injury & to gain nature of the injury & to gain expert advice on the expert advice on the rehabilitation program requiredrehabilitation program required
THANK YOU……………….THANK YOU……………….